Tuesday, January 19, 2016


I still haven't gotten internet on my phone or in my new condo, which has a lot to do with why I haven't updated this lately. Yesterday I went over to my parents' place in order to check my email and while I was at it I thought I'd follow up on a few things I'd been wondering about diabetes wise. Maybe you haven't wondered enough to look it up either:

Q1. So did they come out with anything really left-field about diabetes lately? Anything in the realm of a cure?
A1. No.

Q2. Now that Lantus is no longer protected by patent, has anybody made a generic available in the US? Talked about making a generic?
A2: Glad you asked! It's even more complicated than that. Only three days ago, the FDA approved a second insulin glargine in an accelerated process that doesn't call it a generic, because " No insulin glargine products are currently licensed under the Public Health Service Act, so there is no “reference product” for a proposed biosimilar product.".It is going to be sold by Eli Lilly in disposable insulin pens only, and not until December 2016. There's no word as to cost, but given that it will be available in pens only, and that the seller will be Lilly, I'm guessing it's not going to signal a really dramatic decrease in cost. But it should still curtail the price hikes that Lantus has had in the past few years.
Eli Lilly was required to do some human testing with their product, and the tests showed worse blood sugar control with their insulin glargine vs lantus, but not dramatically so, therefore it was declared "non-inferior".

Q3: Some time ago, I got an email from minimed saying they had a NEW more accurate version of the enlite sensor. How's that new version of the enlite perform anyways? When my dexcom breaks down, should I consider switching back?
A4:  As far as I can tell, the new sensor is only available in Europe (so why'd they email me? Don't know). The UK minimed site states: Data on file ER13-7989 Enlite with MiniMed Paradigm® Veo™ System has a MARD of 14.2 % while Enlite with MiniMed™ 640G System has a MARD of 13%.
In comparison, Dexcom G4 with the old software had a MARD of 13%, and according to Dexcom, the new software improved performance to 9%.
So if accuracy is your only consideration, you shouldn't consider the new Enlites.  Given cost however... and my pump is still under warranty.

Q4: What new diabetes studies are being conducted in my area?
A4: Well, there's a study on using dapaglifozin in type 1 diabetics. I am still of the opinion that this medication is likely to lead to so much increased kidney mortality that it will eventually be recalled. I would not recommend enrolling in this trial.
There's another study on the insulin patch Finessa, which has already been FDA approved but which you can't buy yet.
There's a few studies trying to treat newly diagnosed type 1 diabetics, and one that aims to compare the intestinal flora of the newly diagnosed to healthy people; that strikes me as being difficult to really control.

Myself, after finishing up with the pump supplies I had in November, I used a vial of Lantus for a month and I moved onto NPH about six weeks ago. For whatever reason, using NPH this time has been much smoother than it was when I tried it last time, maybe because I'm taking it at different times of day (midmorning and bedtime rather than breakfast and supper).
Did I say blood sugar has been smooth? Exclude the last few days- I've been having digestive problems where I eat a meal (after injecting Regular), go low, stay low for a while (like a couple of hours), and then shoot way up.
I am still in the licensure process of fostering and/or adopting in Illinois, but a few weeks ago I met a child who is being considered as a potential match with me (I say YES but there are a lot of agencies involved that all have to also approve). He is not diabetic.